Yellow Fever

Yellow fever (YF) is a viral disease transmitted by mosquitoes causing a spectrum of disease from mild to severe symptoms. Mosquito bite avoidance and yellow fever vaccination is recommended for travellers visiting countries where there is a risk of YF virus transmission. Under the International Health Regulations (2005), an International Certificate of Vaccination or Prophylaxis for YF may be an entry requirement for some travellers to YF risk countries. YF certificate requirements are not necessarily connected to the risk of disease for a traveller. The YF vaccine is only available at designated UK Yellow Fever Vaccination Centres (YFVCs). There is no treatment for YF disease. Care of an infected person is based on managing the symptoms.

THE MEDICAL JOURNAL OF AUSTRALIA NOVEMBER 1, 1952 Considering the great Importance of malaria in tropical practice, and the enormous accumulation of recent information on its various aspects, the sections on this disease are wholly Inadequate. The subject of treatment, of which a proper appreciation is at present rendered difficult to practitioners by the amount of published material appearing, is covered in about three pages. A similar deficiency exists In the section on control measures, where the use of pyrethrum and paris green receive the same space as that of DDT. Blackwater fever is dealt with in "a few clinical points" In little over a page. In a work of this size, It Is not enough to be told that blackwater fever Is "not too common", or that a "navy clinician who spent more than a decade in malarial areas saw only three cases in nine years . . .". For It is when one of these rare cases suddenly appears that the practitioner, often far from consultative help, will turn to his reference book, and will reasonably expect some guidance In his procedure.
Despite the above criticisms, the book contains many excellent sections, and presents much of great interest to tropical clinicians. For the reasons mentioned, however, it is not recommended to Australian students, or to practitioners in the Australian tropical territories.
GYNlECOLOGY. J. P. GREENHILL'-S "Surgical Gynecology'" is an excellent companion volume for his "Office Gynecology". It Is suitably condensed and, as the preface suggests, it was prepared for young gynrecologists and general practitioners, who also perform operations. Nearly all the gynrecologlcal operations have been pictorially described in as simple a way as possible. The clinical aspect of gynrecology has been omitted, but an informative chapter on pre-operative preparation and post-operative care and complications is well done, particularly the discussion of water and electrolytic balance, early ambulatlon, shock, antibiotics and chemotherapy, and pulmonary and intestinal complications.
The description of operations for carcinoma of the vulva and cervix could have been omitted with advantage as they transgress the alms and usefulness of this book.
Few gynrecologists would agree with the inadequate excision of a vulval growth shown, which would certainly Invite a recurrence, nor with the method of lymph node dissection in the Wertheim's radical hysterectomy.
However, Greenhill's well-known clarity of description is greatly aided by the wealth of excellent illustrations of the operations described.

YELLOW FEVER.
"YELLOW FEvER", by Dr. George Strode and eight colleagues of the Rockefeller Foundation, Is distinguished as the most comprehensive treatise yet published on this subject.' It is also a monument to the classical achievements of the International Health Division of the Foundation, of which Dr. Strode, the editor, is director.
In 1916 the Rockefeller Foundation established its Yellow Fever Commission, with the aim of eradicating yellow fever from the world. An epic attack on the problem was made from all sides by coordinated laboratory and field studies, supported by the vast resources of the Foundation. The cost of the project, to 1949, amounted to 14 million dollars, and the lives of six workers, who died of yellow fever. But though it was shown that the virus was entrenched In sylvatic haunts, and could not be eradicated, successful control measures were evolved. The achievements Included the control of the urban mosquito vector, the discovery of an unexpected forest reservoir of the virus In monkeys and sometimes other animals, with transmission by bush mosquitoes, the development of protective vaccine, and the mouse protection test, which discloses the distribution of infection in populations. The extent to which the Foundation has identified itself with our present knowledge of yellow fever is indicated by the fact that this volume Is largely based on the work of Its own staff, and of agencies receiving its support and cooperation.
The book deals with both the preventive and the clinical. aspects of yellow fever, including its transmission, pathology, epidemiology, immunology and clinical features. The writing Is uniformly of high standard, and Dr. Strode is to be congratulated upon his editing. In all respects the volume Is worthy of the great work It represents. It is excellently printed, well Illustrated, and handsomely bound.
Although the areas of yellow fever endemicity are distant from Australia, the presence here of Aedes regypti, its urban vector, and the increasing risk of Its Introduction by air passengers, render the disease of more than academic importance to Australians. The book is essential for all health department and health laboratory libraries, as well as for medical ltbrartes generally. As well, the wide biological implications of the subject should make it of interest to a large field of scientific workers. There is a detailed account of the symptoms and signs, differential diagnosis and complications.
Fifty-three patients were examined by questionnaire, but nothing new was discovered, and It is surprising that smoking is hardly mentioned in relation to the disease.
In 300 patients the morbid anatomy and cause of death are described, the commonest being right ventricular failure. A detailed bacteriological examination of the sputum in 50 cases showed the expected mixed and variable bacterial flora, which was only transiently modified by antibiotics.
Tested against coloured water, the expectorants were shown to be of no value, as their name would suggest, in promoting sputum production. The amount was extremely variable, 0 to 90 millilitres in twenty-four hours, and changes were more related to the weather than to cough mixtures. A similar experiment with sedative drugs showed equally little effect in the usual doses. There were no controls in the author's Investigation of antispasmodic drugs, but he gives a clinical preference for aminophylline and "Benadryl" and considers these to be of value. It will be debated whether digoxin is contraindicated when the heart fails in this disease; the author prefers ouabain. 'He emphasizes the value of chest exercises and suppression of useless coughing; however, the disease remains one difficult to treat, and in this detailed account there is little that is new.
There are 32 illustrations, and a full bibliography at the conclusion of each chapter.
NEW WORLDS AND OLD.
IN a small volume of thirteen short essays, "New Worlds and Old", Professor Charles Singer has given us more of the fruits of his learning and long experience in a choice selection of biographical and philosophical dissertations.' As might be anticipated in consideration· of the ripe scholarship of this eminent medical historian, these few essays make delightful reading as we follow the evolution of scientific and religious ideas through the centuries; while considerable demands are made upon our powers of mental . concentration if we take the trouble to refiect seriously upon the mighty impact of the "new philosophy" on a timeworn system of theology. However, those chapters likely to have a more ready and direct appeal by reason of their less weighty content deal with such subjects as Copernicus and Vesallus, the microscopic studies of Robert Hooke, '''Chronic Bronchitis", by Trevor H. HoweiI, M.R.C.P.Ed.; 1951.